Ankle Sprain: Rehabilitation (PART III)

After an ankle sprain, proper rehabilitation is key to returning to activity quickly and to prevent additional injury later. An injury as common as an ankle sprain can have long lasting effects, if not treated properly. Like most athletic injuries, there are 3 keys to proper ankle rehabilitation. Range of motion (ROM), strength and proprioception will be covered in greater detail below.

1. Gaining proper ROM is the first step to recovery from any type of ankle sprain. Both passive and active ROM is necessary and simple exercises such as a towel stretch can help achieve this goal. Using a towel (or a belt) stretched over the ball of the foot, and pulling the ankle into dorsiflexion is an easy exercise to gain passive ROM. An example of an active ROM exercise is the ABCs, writing out the alphabet with the tip of the toe.

2.Improving strength is the next step in the rehabilitation process. Joints have both static and dynamic stabilizers. A ligament, the static stabilizer, takes many weeks to scar down to prevent further injury. The surrounding musculature, the dynamic stabilizer, is key to protecting the ankle when returning to play quickly. The stabilizer muscles of the ankle can support the ankle in addition to external taping and bracing to allow an athlete to begin to return to play before the injury has fully healed, saving valuable weeks in a season or participating in a schedule event they would have otherwise missed. A resistive exercise, such as 4-way ankle exercises with a theraband, is an example of a strengthening exercise.

3. Proprioception is the ability to sense a stimulus from within the body regarding position, motion, and equilibrium. This essentially means the body can tell where a joint is in space and make proper adjustments based on neural feedback. Regarding the ankle, the most common form or proprioceptive rehab involves balance. This can be as simple as standing on one foot and as difficult a standing on an unstable surface while playing catch or other sport specific motions.

These three principles can and do overlap in most rehab exercises but it is important to have a solid foundation in each area before moving to the next. Strengthening an ankle with poor ROM will lead to an altered gait and additional issues further up the kinetic chain. Training for proprioception with insufficient strength can be dangerous and lead to repeat injury. The physical therapist and athletic trainers at Advanced Orthopaedic Specialists are happy to assist you with setting up a home exercise plan or more advanced rehabilitation in our physical therapy clinics in Fayetteville or our brand new Pinnacle Hills location.